AIM: To analyze possibilities of surgical treatment of aneurysm of ascending aorta (AAA) by wrapping tape operation (WTO) .
METHODS: During 1996-2011 yy 703 patients (pts) with aortic valve disease (AVD) and AAA were consecutively operated in Institute. The average age was
55,3 ±7,9 (21 - 71) yy. At all group 9 (1,3%) pts were in II NYHA class, 268 (38,1%) pts in III and 426 (60,6%)
pts in IV. The following operations were performed: aortic valve replacement (AVR)
+ wrapping tape operation (WTO) of ascending aorta (AA) - 218 (31,0%) pts (group A), AVR without correction of AAA(diameter of AA 4,9± 0,5 cm) - 421 (59,9%) pts (group B), Benthal’s (n=57) and Wheat’s (n=7) operations –
64 (9,1%) pts with AAA (diameter of AA 6,6±0,8 cm) + combined aortic valve disease (group C). In all cases in group A after AVR nylon tape (diameter 1cm) was wrapped on AA by 5-9 tours and fixated between them in proximal and distal part of AA.
RESULTS: Hospital mortality was 1.4%, 1.7% and 4.7% in groups A, B, C consecutively (p<0.05). During remote period (8,5±0,7 yy) deaths occured in 2.4% (n=5/205), 9.0% (n=37/409) and 3.3% (n= 2/60) (p < 0.05) in groups A, B, C consecutively. Reoperations (AA`s graft replacement) were performed in 0% (n=0/205), 1.7% (n=7/409) and 0% (n=0/60)(p<0.05) in groups A, B, C consecutively. Echo examination of diameter of AA for group A (cm): preoperative (PRE) 4.8±0.5, postoperative (POST) (6–7 days) 3.8±0.3, remote period (REM) 4.0±0.3; for group B: PRE 4.9±0.3, POST – 4.7±0.4, REM 5.3±0.4 and for
group C: PRE – 6.4±0.4, POST – 2.9±0.3, REM 3.0±0.2.
Unsatisfactory results were marked in 2.4% (n = 5/205),
11.5% (n=47/409) and 3.3% (n= 2/60) in groups A, B, C consecutively (p<0.05 ).
CONCLUSION: We recommend WTO for moderate forms of AAA (AA≤5,5 cm) during AVR. It
is safe, cheap operation which prevents formation of AAA at the remote period.
